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Embolic inner ear decompression illness: correlation with a right-to-left shunt
Christoph Klingmann1, Peter John Benton, Peter Arthur Ringleb
1Department of Otolarynology-Head and Neck Surgery, University of Heidelberg, Germany. christpoh_klingmann@med.uni-heidekberg.de
The Laryngoscope
|August 5, 2003
Summary
Inner ear decompression illness, a condition in divers, may be more common than previously thought. Prompt recompression therapy is crucial to prevent permanent disability in affected recreational divers.
Area of Science:
- Diving Medicine
- Neurology
- Otolaryngology
Background:
- Inner ear decompression illness (IEDC) is considered rare in recreational diving.
- Symptoms of inner ear dysfunction are often misattributed to inner ear barotrauma.
Purpose of the Study:
- To investigate the occurrence and characteristics of IEDC in recreational divers.
- To highlight the potential underdiagnosis of IEDC.
Main Methods:
- Case series of nine divers presenting with inner ear dysfunction.
- Diagnosis of significant right-to-left shunt using transcranial Doppler sonography.
Main Results:
- All nine divers diagnosed with IEDC exhibited significant right-to-left shunts.
- Intravascular bubble emboli are proposed as the causative mechanism.
Conclusions:
- IEDC may be more prevalent in recreational divers than currently recognized.
- Prompt recompression therapy is essential to prevent permanent disability.
- Immediate recompression is recommended for divers with inner ear symptoms post-dive, even if barotrauma is suspected.